This is a very personal article and although it is specific to me, I have a feeling many of you find yourselves here, too.
I’ve come to accept the fact that the management of my health will always be a journey and not a destination. If you are familiar with the Buddhist way of life, you are probably smiling. And, if not – in short, it just means embracing life as it unfolds, treating it with appreciation, kindness, and forgiveness rather than be solely focused on a specific goal. Because the reality is — we tend to lose ourselves in the pursuit of goals, never live in the present, never appreciate what we have – and once we reach the destination/goal, we are still not happy and we want more.
This is a very personal blog post that details the challenges and steps I have taken in the past year on my continuous journey of healing. It might be specific to me but I have a feeling that many of you will find yourselves in my tales, too.
Hyperthyroidism (Graves’) and hypothyroidism (Hashimoto’s)
I think I had hormonal drama going on since my early twenties; I just had no idea why I was feeling this way. I wrote about my thyroid battles and what I did to reverse and manage them, which you can read about here.
Both of the thyroid conditions were autoimmune-related. It means my immune system was launching an attack on the thyroid gland. You might be wondering about the connection between an autoimmune condition and a hormonal imbalance. Let me assure you, there is a big one, even though in Western (allopathic) medicine, they like to dissect us to “systems” – as if the brain, digestive and nervous system were not connected to each other.
What I have learned is that the digestive system houses 70% of the immune system and that when it is in distress, not only does it trigger the immune system to misfire (this is why I had two autoimmune conditions) but it also puts us it a state of stress which stimulates cortisol overproduction. So there you have it: cortisol. The king of steroid hormones that gets us through crisis moments (we can’t live without it) and gets us in trouble when it is too much, for too long or too little of it.
In spite of my thyroid doing great, I started experiencing hair loss in 2010.
By 2010, after two years of dietary and lifestyle changes which I talk about here, my thyroid started doing much better. By “better” I mean: my TPO antibodies dropped, I was no longer fatigued, had no more heart palpitations and terrifying anxiety attacks. My mood improved and I felt like being social and kind to people again. I say “again”, as this was not the case when I lived in Shanghai, China when my health was at its worst.
But, now my hair started falling out – a symptom I did not experience earlier. So it felt like managing my thyroid was a moving goal and a rather mysterious one as all lab work proved to be OK. An integrated doctor in Seattle (where I lived in 2010) told me that I was the “healthiest person he had seen in a long time”. That was not helpful.
I then moved to NYC and one of the first things I tasked myself with was to find a good physician who was willing to run the tests I requested and who understood the peripheral body systems that impact the thyroid and cause hair loss.
Hair loss is just a sign that there is an imbalance going on in the body.
The easiest thing to look at first were vitamin and mineral deficiencies so I went down that path – zinc, calcium, more meat proteins, biotin, iron, and silica. Yup, did them all and still had no results. Out of desperation, I even went on Cytomel (a synthetic T3 thyroid hormone) for three months. It temporarily helped but it stopped working after two months and the hair loss came back.
Finally, I found a doctor who ran a battery of tests, including DHT (dihydrotestosterone), cortisol, heavy metal panels and estrogen levels.
Verdict: heavy metal toxicity, estrogen dominance and adrenal fatigue Stage 2.
I had high levels of mercury and lead both in my urine (indicator for past exposure) and blood (indicator for current exposure). This was hardly surprising as I had a mouth full of old amalgam fillings and lived in China for over four years where I fearlessly ate seafood and fish – partly in denial and partly in ignorance.
It’s the second diagnosis, estrogen dominance, that threw me off. Me? Estrogen dominance? I’ve not been on birth control pills for years, I eat clean food, I don’t use plastics at home, I select clean skin care products and I exercise regularly. How can it be?
I still remember watching one of the great health/alternative medicine documentaries on Netflix that featured a woman diagnosed with breast cancer who said “I was the annoyingly healthy person. I never ate crap. I never fell sick. I never had a weight problem. Breast cancer was the worse thing God could ever punish me with.” I heard and felt every word she uttered.
In case you do not know this, estrogen dominance is the leading cause of breast cancers and osteoporosis in women. It can also contribute to autoimmune diseases and both Graves’ and Hashimoto’s fall into this group.
My estrogen dominance was diagnosed based on a simple blood test called the 2:16 Hydroxyestrone Ratio (more details below). You can also get it tested through saliva and get a better view of the different estrogens, progesterone and their relationship to each other. I share more about saliva hormone panel testing here.
What does it mean to have estrogen dominance?
I am going to borrow the explanation from Dr.Dan Lukaczer, N.D., who is director of clinical research at the Functional Medicine Research Center. He explains it so eloquently:
“In premenopausal women, the ovaries produce the estrogen estradiol (E2), which converts into estrone (E1), both of which must eventually be broken down and excreted from the body. This breakdown occurs primarily in the liver, and the excreted metabolites flow out in the bile or urine. Estradiol and estrone undergo this breakdown through a process called hydroxylation. (…)
What makes an estrogen good or bad? That has to do with the biological activity, or potency, of that estrogen. Estrogens are important in a host of cellular activities that affect growth and differentiation in various target cells. This is normal and beneficial, but too much estrogenic stimulation can have a negative effect.
Therefore, properly metabolizing and excreting estrogens is crucial.. If these estrogens are metabolized into the 2-hydroxylated estrone and estradiol, they lose much of their cell proliferative and estrogenic activity and are termed “good” estrogen metabolites. Studies show that when 2-hydroxylation increases, the body resists cancer, and that when 2-hydroxylation decreases, cancer risk increases.”
This was a humbling experience. After all, I teach people how to live clean, yet, I’m a perfect candidate for breast cancer now? Losing hair was just the onset of the bigger storm that was yet to come.
Can you see yourself in this? You eat well, you exercise, you don’t drink diet Coke.
So many of you write to me and say “I’m eating so well, I exercise, I try not to be stressed and I’m still not 100%. What is going on?”
And this is what I mean by my own health and healing being a journey. It’s not about the thyroid anymore, at least not for me. My thyroid numbers are and were perfect (apart from the TPO antibodies). It often can be about the peripheral body systems that are impacting you.
You know what I love about it? Every crisis makes me dive deep into understanding what is going on and WHY is it happening.
Of course, the next step for anybody with a Type A personality is to dive into action. Yup, that’s me. Embrace it and battle it. Head on.
And so I did.
How do I reverse adrenal fatigue, estrogen dominance and heavy metal toxicity?
First stop: the internet.
A bad idea. A very bad idea.
Do you remember when you first got diagnosed and Googled your own hormonal condition and got thousands or millions (literally) of pages coming up? You suddenly found yourself in a jungle of information; overwhelmed and confused with all the contradictory information. Not to mention the supplements and magic pills each website promises to heal you with. And forget online forums, they make you feel like you should be dead by now.
This was my path, too. Google “heavy metal detoxification” or “estrogen dominance” and see what you get. I wanted to cry and my heart started pounding as I didn’t know where to start and who to trust. And believe me, I’ve learned over the years about my credible go-to sources.
My action plan to healing.
I took a deep breath and slowly, over the next few weeks, I came up with an action plan. Which read:
- Get rid of the heavy metals
- Remove all my amalgam fillings.
- Support my liver.
- Have a solid liver detox in place supporting the Phase 1 and Phase 2 detoxification process.
- Re-balance my estrogen levels:
a. Internally: again, support my liver and especially the methylation and sulphication pathways of the liver as they excrete metabolized (or “used up”) estrogens.
b. Externally: diligently get rid of any xenoestrogens (sythetic version of estrogens) found in my house cleaning products, skin care, cosmetics and perfumes.
4. Address my elevated cortisol level.
So I got to work.
Step #1. Removed the biggest source of mercury: my amalgam fillings.
First stop: in January 2013, I had all my six amalgam fillings removed by a holistic dentist who specializes in mercury removal. It was expensive ($4,000 for six fillings) and in spite of all the precautions she took and the amino acid protocol I was on, I felt terrible for three days and slept 14 hours each day. But, I recovered from this fatigue soon after that.
Step #2. Started juicing daily.
I dusted off my juicer (well, not really, but actually started using it every day) and started juicing vegetables that are known to cleanse the liver. No raw cruciferous veggies here, as they can be detrimental to the thyroid when in raw form.
Step #3. Upped the cruciferous vegetables.
In case you don’t know what they are, it’s the brassica (or cabbage) family of goodness like kale, broccoli, chards, spinach, cauliflower, etc. In their raw form, they are known to slow down the thyroid and this is why, if you are a thyroid patient, you should consume them in a cooked form. Many websites and writers have an obsessive tendency to view nutrition in black and white and recommend for people with thyroid conditions to cut them out completely. I don’t agree with this approach – most of my clients eat cooked cruciferous veggies in moderation and heal well.
Why I like cruciferous vegetables? They are the superstars of the vegetables; there are no other veggies that are as rich in Vitamin A carotenoids; Vitamin C; folic acid; Vitamin K (which regulate our inflammatory responses – very common in people with autoimmune and inflammatory conditions) and fiber. As it is, most people are nutritionally depleted and rely heavily on supplements which they don’t even absorb properly – so why deprive your body of these wonderful nutrients?
In my own journey since January 2013 till today, I’ve added at least 1-2 servings of cooked cruciferous vegetables per day. In fact, if you see my result below, my TSH (thyroid stimulating hormone) dropped from 1.02 to 0.82 which is most certainly not a sign of going hypo.
In the liver detoxification protocol, I used the cruciferous vegetables because they are key in the Phase 2 process and specifically the glutathione pathway which gets rid of heavy metals, PCBs (endocrine disruptors) and pathogenic bacteria in the liver.
Step #4. Did a major liver detox
Knowing that the liver is largely responsible for the neutralization and elimination of mutated and excess hormones like thyroid and estrogen, I embarked on a highly tailor-made liver detoxification protocol. Even though I’ve lived a very clean life for the past seven years, it appeared that there are still residual burdens that inhibit the liver from detoxing our body properly.
If you wonder about the symptoms of a sluggish liver, read this post. It’s key to your healing to understand the Phase 1 and Phase 2 part as well as the different detoxification pathways that will help you get back on your feet.
Step #5. Added an amino-acid protocol.
I got on a strict protocol of a combination of amino acids that help the liver pathways in detoxifying the mutated hormones, including thyroid and estrogen hormones, and ridding the body of heavy metals. I refused to do chelation therapy which might produce quick results but feels invasive to me. Instead, I chose to go slower but do it organically.
Step #6. Minimal supplements.
If you know me well, you know I’m not a fan of these, for many reasons. So I limited them to only two things: passionflower extract and a DIM supplement that blocks the receptors for the E2 (estradiol), the aggressive estrogen.
Step #7. De-stressing to reduce my cortisol levels.
I was pretty aware that a romantic relationship I was in was going south and it had a big impact on my stress levels. I also took on too many work projects which were depleting me.
Solution? I walked away from the relationship (very hard at first but it felt so much lighter later) and went back to doing a 20-minute meditation every morning to start the day on the right foot. I also frequently make some time to sit in silence and just breathe deeply into my lower abdomen whenever I find myself overwhelmed, annoyed or just having a racing mind.
I also cut out my habitual morning espresso and switched to matcha green tea. Adrenals hate coffee and sugar.
I did not go for any adaptogens many practitioners prescribe to patients with adrenal fatigue or overactive adrenals.
In April 2013 I got back from my doctor’s office who is totally on board with the madness of tests I wanted him to run (I love this kind of doctor – works with you in partnership and does not get intimidated by you knowing a bit about your own body) and he said to me: “How did you do it?”
“What did I do?” – me, confused.
“Your numbers look really good,” – him, smiling.
We all like to see a person smile and this smile was different.
I kind of knew that something had shifted in my own body over the past few months.
- My hair loss stopped and I started having lots of baby hair growing back.
- My PMS is totally gone – even on my good days I always had a bit of a mood dip not noticeable to others but me. Now I feel n.o.t.h.i.n.g.
- My periods are painless and I do not get bloated at all. ( Yes, this is yet another symptom of estrogen dominance that we’ve grown to accept it as a “norm” of every woman’s menstrual reality.
- Those darn seven strands of hair under my chin and rather dark hair above my lips stopped growing. Facial growth (under your chin and above your lips) could be a sign of estrogen dominance but also of high androgens (testosterone and/or DHEA).
All of it is not surprising, as my lab work has significantly improved, namely:
- My TPO antibodies dropped from 138 to 66 (more on that below).
- The marker for estrogen dominance (ED), 2:16 a-Hydroxyestrogen improved from 0.35 to 0.54 which means I no longer have ED.
- My mercury and lead levels dropped to “normal” levels.
- My cortisol levels are mostly in “normal” range, too with a slight elevation at 12.30pm – something to work on.
- My reverse T3 (rT3) dropped significantly – this is another great marker to observe as it’s often elevated due to estrogen dominance and adrenal issues. rT3 acts like T3 but instead of powering you up, it parks itself in the T3 receptors, does nothing and worse still, it blocks the real T3 from coming in and doing its job. T3 is what gives you healthy hair, good skin, energy, clarity of mind, etc.
I scanned my results and highlighted the changes – before and after.
==> Estrogen dominance reduction (click below to see in full)
===> Cortisol (stress hormone) reduction (click below to see full size)
==> Heavy metal (mercury and lead) reduction (click below to see full size)
==> Reverse T3 reduction (click below to see full size)
But, there is more work to be done.
Is it perfect yet? No.
It’s the journey, remember?
I still have to work on what I suspect is my gut absorbability.
In spite of eating meat 3-4 times per week and taking vitamin B complex, my B12 is only 348 and I would like it to be in the 800 range as that’s what is recommended by functional medicine for people with autoimmune conditions.
The same thing goes with my Vitamin D levels – in spite of taking perhaps not a high enough dose of fermented cod liver oil (I like this one), I would like it to go up higher. I suspect it’s the same issue with my gut’s ability to absorb vitamins and minerals.
Furthermore, even though my TPO antibodies are lower than ever now at 66, I want to get them down to below 30. This will classify me being free of Hashimoto’s. Even though I have no symptoms of hypothyroiditis (remember that the hair loss was due to either ED and/or heavy metals and not the thyroid), I still want to get them below 30. Because this is my work.
Here is what my next action plan is: test for gluten cross-reactivity. There are foods that may not contain gluten but our body’s immune system labels them as antigens if you have a gluten sensitivity (which I obviously do). The list is a little scary: chocolate, quinoa, rice and hemp seeds are on this list, too. Ouch. They all happen to be a part of my regular diet. It does not mean that I (or you) have a sensitivity to all of them but even eating one of them can be causing digestive dysbiosis and hence the absorbability issue.
If you want a more scientific explanation on gluten cross-reactivity, go to this good source.
What can you do?
1. Find out which hormones are out of balance.
There are several things that you can and should do as a foundation of your overall health – digestive health restoration and liver detoxification are on the top of the list.
Once you get these done but still feel “off” I encourage you then to dive deeper. You can do it easily online by taking our Hormones Balance Quiz or order saliva hormonal panel test from us. The advantage of ordering it here is that you do not have to pay doctor fees.
2. Take action.
One of the first steps I take with my clients is to restore their digestive health. There can be no hormonal balance with a digestion that is stressed. Here I mean experiencing chronic constipation, diarrhea, gas, bloating, stomach ache, burping and acid reflux. These need to resolve first.
One of the most powerful ways I found to get someone started is to do an Elimination Diet to identify the food intolerances you might be experiencing. Functional medicine believes that 70% of today’s population suffer from some food sensitivity or another. Remember these elevated cortisol levels? Well, a stable digestion will help lower them, too.
After that, it’s your liver that needs support. I talk more extensively on the role of the liver in this article.
Be well, have hope and take action to heal.